Hip osteoarthritis can create a difficult cycle. The hip hurts, so you move less. Because you move less, the surrounding muscles lose strength and ordinary activities become harder. Walking feels more demanding, so you move even less. Breaking that cycle is one reason exercise is central to modern osteoarthritis care.

What is hip osteoarthritis?

Osteoarthritis is a joint condition involving changes to cartilage, bone and other structures within and around the joint. In the hip, symptoms may include pain around the groin, front or side of the hip, stiffness after rest, difficulty putting on shoes or socks, or reduced tolerance for walking and stairs. Symptoms and X-ray findings do not always match perfectly, so treatment decisions should consider the person rather than the scan alone.

Is exercise safe when the joint is arthritic?

For most people, appropriately selected exercise is not something to avoid. NICE recommends therapeutic exercise tailored to individual needs for all people with osteoarthritis, including local strengthening and general aerobic fitness. The guideline also advises explaining that some discomfort can occur when exercise begins, while regular adherence can improve pain, function and quality of life over time.

What does physiotherapy target?

A physiotherapist may assess hip movement, muscle strength, walking, balance, sit-to-stand ability, stairs, work demands and other joints contributing to difficulty. Treatment often combines education with progressive strengthening and aerobic activity. Revive already has a detailed article on knee pain and arthritis, which reinforces the wider principle that arthritis care usually begins with function, strength and activity rather than jumping straight to surgery.

Should painful activities be avoided completely?

Usually the better approach is to adjust them. If a 45-minute walk repeatedly causes a major flare, the choice is not necessarily between continuing 45 minutes and doing no walking at all. A starting point might be shorter walks, a slower pace or a lower-impact cardiovascular option such as cycling or pool exercise while strength is rebuilt. Revive's hydrotherapy and treatment services page lists water-based rehabilitation among its available options, which can be useful for selected patients who find land-based exercise difficult.

What about older adults?

Hip osteoarthritis is common later in life, but age should not automatically be treated as a reason to reduce movement. Revive's article on physiotherapy and independence in older adults explains how strength, balance and mobility are closely linked to everyday function. For someone with hip arthritis, goals might include getting up from low chairs, walking comfortably through a shopping centre or using stairs with less difficulty.

Does physiotherapy prevent everyone from needing surgery?

No. Some people manage hip osteoarthritis for years with exercise, activity modification and other conservative care. Others eventually develop symptoms and limitations for which joint replacement is considered. Physiotherapy should not be marketed as a guaranteed way to avoid surgery. Its role is to improve function, maintain strength, support self-management and help patients make the most of nonsurgical care. If surgery is later chosen, maintaining capacity beforehand can also be useful.

When should hip pain be checked?

Seek professional assessment if pain is persistent or significantly limiting function. Urgent evaluation is warranted after major trauma, inability to bear weight, a hot swollen joint, fever or other concerning symptoms. Do not assume every groin or hip pain is osteoarthritis without assessment.

The practical takeaway

An arthritic hip is not necessarily a hip that should stop moving. The aim is to find an amount and type of movement the joint can tolerate now, then gradually improve capacity. In osteoarthritis management, exercise is treatment, not a test you must pass before treatment begins.

Related Revive resources

• Knee Pain and Arthritis

• Physiotherapy for Elderly Independence

• Physiotherapy Services

Sources

• NICE - Osteoarthritis in over 16s: diagnosis and management (NG226)

• AAOS OrthoInfo - Osteoarthritis of the Hip

• American College of Rheumatology / Arthritis Foundation OA Guideline

Medical disclaimer: This article is for general informational and educational purposes only. It does not provide a diagnosis or personalised treatment plan and does not replace advice, examination or treatment from a qualified doctor, physiotherapist or other healthcare professional. Seek appropriate medical attention for severe, rapidly worsening, traumatic, neurological or otherwise concerning symptoms.